Please take a moment to read this article written by Melissa Walton-Shirley, MD, Echocardiography:The Good, The Bad, and The Ugly - Medscape - Nov 05, 2018. This article perfectly sums-up why we need tools such as Introduction to Echocardiography and Echo Test and Teach both for both training and quality improvement. Reducing variability will always be a challenge, but it should be the ultimate goal in order to provide the best patient care.